Venepuncture ~ Basics and Troubleshooting, Vacutainer Colour codes in Blood sampling and tube types used
Venepuncture is the puncture of a vein as part of a medical procedure, typically to withdraw a blood sample or for an intravenous injection.
Veins to be used are:
• METACARPAL VEINS
• CEPHALIC VEIN
• BASILIC VEIN
• MEDIAN CUBITAL VEIN
Attributes of an ideal vein are:
Veins to be avoided:
Methods for improving venous access:
• Apply a tourniquet
• Lower the level of the arm below the heart
• Ask the patient to open and close their fist
• Light tapping / rubbing of the veins
• Relax the patient / consider the environment
• Warm up the patient’s hands
• DO NOT re-touch or palpate the vein once cleaned!!!
• The needle should form a 15 to 30 degree angle with the surface of the arm.
3. PROBLEMS OTHER THAN AN INCOMPLETE COLLECTION:
Haematoma/Bruising can be caused by:
• Tourniquet too tight / left on too long or use of RUBBER GLOVE!
• Arterial puncture
• Repeated insertion sites
If you stick yourself with a contaminated needle:
• Remove your gloves and dispose of them properly.
• Squeeze puncture site to promote bleeding.
• Wash the area well with soap and water.
• Record the patient's name and ID number.
• Follow your hospital protocol regarding treatment and follow-up.
Order Of Draw:
NOTE: NEVER FORCEFULLY EJECT THE COLLECTED BLOOD FROM THE SYRINGE INTO THE VACUUM TUBE.
Causes Of Hemolysis:
Vacutainer Colour codes in Blood sampling:
Thromboelastography (TEG) is an important assay to incorporate into anesthesia practice for development of evidence-based therapy of trauma patients receiving blood transfusions. The leading cause of death worldwide results from trauma. Hemorrhage is responsible for 30% to 40% of trauma mortality and accounts for almost 50% of the deaths occurring in the initial 24 hours following the traumatic incident. On admission, 25% to 35% of trauma patients present with coagulopathy, which is associated with a sevenfold increase in morbidity and mortality. The literature supports that routine plasma-based routine coagulation tests, such as prothrombin time, activated partial thromboplastin time, and international normalized ratio, are inadequate for monitoring coagulopathy and guided transfusion therapy in trauma patients.
A potential solution is incorporating the use of the TEG assay into the care of trauma patients to render evidence-based therapy for patients requiring massive blood transfusions. Analysis with TEG provides a complete picture of hemostasis, which is far superior to isolated, static conventional tests. The result is a fast,
well-designed, and precise diagnosis enabling more cost-effective treatment, improved clinical outcome,
accurate use of blood products, and pharmaceutical therapies at the point of care.
transfusion therapy, trauma
To Know More About TEG:
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A helpful mnemonic is "DR MAGICAL"
No single feature is pathognomonic, although a cystic lesion that markedly restricts centrally (the fluid component) on DWI should be considered an abscess until proven otherwise.
Many features of the lesion as well as clinical presentation and patient demographics need to be taken together to help narrow the differential. Helpful rules of thumb include:
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